Identify members trending toward high-cost claims early enough to actually intervene.
RiskFlow continuously scores every member in your book against clinical, pharmacy, and utilization signals — surfacing emerging high-cost claimants before they reach your stop-loss corridor, so your team can act while intervention still changes the outcome.
Early signal detection
AI-driven scoring flags members trending toward high-cost claims weeks or months before the claim lands — while you still have time to intervene.
Pharmacy cost trajectory
Track specialty drug utilization and escalating prescription costs that often precede a catastrophic claim — the leading indicator for stop-loss attachment.
Intervention-ready workflows
Every alert routes to a care manager or pharmacist with a recommended action, estimated savings range, and a calendar slot — not just a notification.
See it in your book
The RiskFlow Command Center shows every scored member, their projected cost trajectory, days to stop-loss attachment, and the recommended intervention — all in one view.